Preparedness strategies and interventions against influenza pandemics: cost-effectiveness
Citation: Pérez Velasco R, Praditsitthikorn N, Wichmann K, et al. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics. PLoS One 2012; 7(2): e30333
What is this? Public health interventions and preparedness strategies are necessary to limit the effect of pandemics such as COVID-19. It is important to know the economic impact of these interventions and the evidence from influenza pandemics might be informative.
In this systematic review, the authors searched for research evaluating the cost-effectiveness of interventions to control or prevent the 2009 H1N1 human influenza pandemic or other potential human influenza pandemics. They restricted the search to publications in English, Spanish, German, Thai and Dutch and did the search in September 2011. They included a variety of types of economic evaluation: cost effectiveness analyses (14 studies); cost utility analyses (16); cost benefit analyses (6); combined cost effectiveness and cost benefit analyses (2); combined cost effectiveness and cost utility analysis (1) and partial economic evaluations (5). All but two of the studies were model based, and most (34/44) focused only on pharmaceutical interventions such as using vaccines and antiviral drugs.
What works: The combination of pharmaceutical and non-pharmaceutical interventions is relatively cost effective for influenza pandemics, compared to providing vaccines or antiviral drugs.
Social distancing, general population antiviral prophylaxis plus closure of schools, and antiviral prophylaxis for household contacts plus closure of schools are cost effective for influenza pandemics.
What doesn’t work: Quarantine of household contacts is unlikely to be cost effective, even for low- and middle-income countries during influenza pandemics.
What’s uncertain: The cost effectiveness of interventions aimed at the general population or targeting specific groups is uncertain for influenza pandemics.
None of the included studies evaluated the cost-effectiveness of public hygiene and disinfection measures.